Journal Name:
Obesity Surgery
Article Title:
Systemic Inflammation in Morbidly Obese Subjects: Response to Oral Supplementation with Alpha-Linolenic Acid
Date Written:
2007
Volume:
17
Number:
0
Page:
341
Author(s):
Faintuch , J.; Horie, L.M.; Barbeiro, H.V.; Barbeiro, D.F.; Soriano , F.G.; Ishida , R.K.; Cecconello, I.
Article:
Increased body weight is associated with elevation of white blood cell count and acute-phase proteins, and obesity is regarded as a low-grade chronic inflammatory disease. Weight loss tends to suppress adipokine production and immunologic activation triggered by excessive fat mass, and corrects undesirable acute-phase reactions. Alpha-linolenic acid (ALA) has been studied as an antagonist of the inflammatory response, and to decrease cardiovascular risk. Besides being markedly anti-inflammatory, by shifting polyunsaturated fatty acid metabolic pathway towards eicosapentaenoic acid (EPA) synthesis, ALA favors the formation of eicosanoids with a predominant antiaggregating and vasorelaxing action, adding to its potential cardio circulatory benefits.
A prospective randomized double-blind cross-over study was designed to assess the effects of ALA on inflammatory response in a group of obese subkects. Forty one outpatient obese subjects were clinically and biochemically screened, and results for 24 randomized subjects are reported. Age was 40.8 ± 11.6 years (83.3% females) and body mass index (BMI) was 47.1 ± 7.2 kg/m2. 30 g/day of flaxseed (5 g of ALA – omega-3) and an equal mass of placebo (manioc flour) were administered for 2 weeks each.
Body weight and general biochemical indices remained stable. Initial inflammatory biomarkers, C-reactive protein (CRP) and serum amyloid A (SAA) were elevated (13.7 ± 9.9 and 17.4 ± 8.0 ). White blood cell count (WBC) ( 8100 ± 2100/mm3 ) and fibronectin (463.2 ± 61.3 mg/dL) were acceptable but in the upper normal range . Following ALA supplementation, these indices were 10.6 ± 6.2 mg/L, 14.3 ± 9.2 mg/L, 7300 ± 1800/mm3 and 412.8 ± 38.6 respectively.
The objective of this study was to determine the effects of ALA from milled flax in asymptomatic chronic activation of acute phase inflammatory markers in morbidly obese patients. In this trial, just 3 g ALA/day for 12 weeks was associated with a 60% elevation of plasma EPA. In this preliminary trial, various inflammatory markers including white blood cell count were elevated in parallel with C-reactive protein. Besides being markedly anti-inflammatory, by shifting polyunsaturated fatty acid metabolic pathway towards eicosapentaenoic acid (EPA) synthesis, ALA favors the formation of eicosanoids with a predominant antiaggregating and vasorelaxing action, adding to its potential cardiocirculatory benefits. Encouraging signs of an anti-inflammatory effect of ALA were clearly present, despite the comparatively modest dosage and duration protocol. Furthermore, persistent effects for up to 2 weeks after discontinuation of the supplement were seen, on the basis of the pattern of white blood cells and fibronectin measurements. Slight reductions in insulin resistance, higher insulin sensitivity and elevated adiponectin were noted. According to the researchers, this metabolic profile is conducive to a healthier metabolic status, with less body fat accumulation.
The focus of the current protocol was inflammatory response, but it was possible to notice that metabolically relevant variables such as glucose, insulin, leptin, plasma lipids and body weight remained stable during both 2-week periods. It is probable that longer periods of supplementation would be required to detect changes in body composition, as well as in fat and carbohydrate oxidation. More prolonged studies are recommended in order to document the effects of ALA in health outcomes of the morbidly obese.
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